Claim total
$767.69
base $93.83 · payer covered $614.14
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-06-25
- Stop
- 2018-06-25
The parties
- Patient
- patient Erwin Eli Hackett
- Provider
- provider Miles Kuphal
- Care site
- care site WELLNESS CENTERS, PLLC
- Payer
- payer Medicare
Record id
24f27ab5-b47f-0e8d-7c8f-207c7ce886fc